For people with toenail fungus, there is no good time to wear sandals. Not even at the beach in July.
Toenail fungus causes nails to become thick, yellow and brittle in a way that looks pretty ugly and can be painful. Sufferers can spend years and hundreds of dollars trying to clear the infection with drugs, topical treatments and home remedies, sometimes to no avail. It tends to be a cosmetic issue for the younger set and a pain issue for older folks.

“The problem is huge. It is bigger than you can imagine,” says Washington podiatrist Stephen J. Kominsky. “I would say 70 percent of the patients who come into my office have fungal infections on their toenails.”

There may be hope. Podiatrists have begun using a laser treatment that combats the infection — or wastes their patients’ money because it doesn’t work, depending on whom you ask.

The treatment, in which the podiatrist aims a laser beam at the patient’s toenails to kill the organisms that cause the fungus, costs about $1,000 and is not covered by insurance because it is considered an aesthetic procedure. The nails aren’t immediately clear after the treatment, which takes up to an hour; the patient must wait for the fungus-free nails to grow out.

Last year, the Food and Drug Administration cleared the first laser, PinPointe, for “temporary increase of clear nail” in patients with onychomycosis, the medical term for a fungal infection of the nail. The FDA cleared a second one, GenesisPlus, in April. Practitioners have been using other lasers on toenail fungus since about 2009.